Treatment of different methods

Polycystic ovaries can not be completely cured, but can significantly reduce its symptoms. This will require the help of a doctor, as well as their own efforts to comply with certain rules.

Lifestyle Changes

Women with overweight weight loss can lead to relief of symptoms of polycystic ovaries, and to reduce the risk of various complications associated with this disorder.

By reducing the weight decreases the amount of insulin produced by the body that you want. This in turn reduces the levels of testosterone and increases the probability of normal ovulation.

Losing weight can not only eliminate the fertility problems and irregular menstrual cycles that are typical of patients with polycystic ovaries, but also to cope with symptoms such as acne and excessive hair growth on the body.

For weight loss is recommended to follow a diet, chosen in accordance with the characteristics of the body of the patient, at least 45-60 minutes a day to devote to aerobic exercise. Typically, the patient consults not only the physician but also a nutritionist. Weight loss of only 5% can lead to significant improvement in symptoms of polycystic ovaries.

Hormone therapy

In the treatment of polycystic ovary can be used drugs that inhibit the activity of male hormones that cause symptoms such as excessive hair growth on the face and hair loss on the head of the male type. These drugs include cyproterone acetate, spironolactone, flutamide, finasteride.

Hormone therapy is also used in violation of the menstrual cycle - is another common symptom of polycystic ovaries. In most cases, patients are advised to take hormonal birth control pills. It normalizes the menstrual cycle and reduces the risk of endometrial cancer.

If treatment with other drugs ineffective, can be assigned to the reception of gonadotropins - hormones that are normally produced in the body and stimulate the ovaries. However, there is an increased risk of ovarian stimulation Ovarian stimulation: if you want to get pregnant   gonadotropins, which can result in multiple pregnancies. Gonadotropins alternative is surgery.

Clomiphene

One of the common problems associated with PCOS, is the inability to conceive. Patients with polycystic women can help a drug for the treatment of infertility Infertility Treatment - What principles are priority   - Clomiphene.

Clomiphene correct hormonal imbalances, increases the likelihood of ovulation and, as a consequence of pregnancy.

Antidiabetic drugs

Antidiabetic drug metformin used in combination with other treatments, helps normalize hormonal women with polycystic ovaries.

Vaniqa cream

Vaniqa cream blocks the action of an enzyme that is in the hair follicles. It slows the growth of unwanted hair on the face, so it is often used in the treatment of symptoms of polycystic ovaries.

Typically this cream is used in conjunction with other products for hair removal Hair Removal: Which method is right for you? .

The improvement is noticeable after four to eight weeks after the start of using the cream.

Surgical intervention

If conservative (medical) treatment does not help to get pregnant, prescribe outpatient surgery - laparoscopy (or electrocautery) ovaries. During surgery, the surgeon makes a small incision in the abdomen, which inserts a tiny tube connected to an optical camera (laparoscope). Thanks to the camera the surgeon can see all the details of the ovaries and neighboring pelvic organs. Then the surgeon through other small incisions and inserts the surgical laser or uses electrical energy to cauterize the enlarged openings in ovarian follicles at the surface.

During the operation, which occurs under full narcosis, ovaries treated, by acting on them and a high temperature laser. The purpose of the operation is to destroy the tissues that produce androgens (male sex hormones) and stimulate ovulation Ovulation - How to determine as accurately as possible? By lowering the levels of luteinizing hormone and androgen. Medicine is not known for sure how this happens. According to one theory, laparoscopy destroyed ovarian cells that produce these hormones.

This operation reduces the level of testosterone and luteinizing hormone (LH) and follicle stimulating hormone levels increase. Thus, it eliminated the hormonal imbalance and recover the normal ovaries.

Marina Solovyov

Medicating

Treatment of polycystic ovary is aimed at addressing the underlying problems facing the diseased woman: infertility, hirsutism (excess body hair), acne and obesity. Term and the most important aspect of treatment is to reduce the stress on the cardiovascular system, caused by obesity, high blood cholesterol levels, diabetes, and hypertension. To choose the right treatment, your doctor will most likely prescribe regular checkups with measurement of blood pressure and monitoring the blood levels of glucose and lipids.

Women with polycystic ovaries, will benefit from the expert advice that will help create a healthy diet and a program of fitness training. This is particularly important for larger women. Completeness of obesity and lower insulin resistance. Losing weight can help lower insulin levels and androgen, and restore ovulation. Unfortunately, women with PCOS lose weight How to lose weight - basic principles   much harder than other women, so it is important regular consultations with the dietician.

To reduce the symptoms and risks associated with PCOS, except for diet and sports, the doctor also prescribe a number of medications.

Medicines to regulate the menstrual cycle

If you are not trying to get pregnant, your doctor may recommend taking small doses of oral contraceptives that combine synthetic estrogen and progesterone Progesterone - norm and pathology . They reduce the production of androgen and allow the body to "rest" of continuous estrogen, which reduces the likelihood of endometrial cancer and restores normal menstrual bleeding.

Alternative treatment - progesterone reception for 10-14 days each month. This treatment option regulates the menstrual cycle and provides protection against endometrial cancer, but does not affect androgen levels.

In addition, possible treatment with metformin (Glucophage, Glucophage XR) - oral medications for treating diabetes 2 degrees, which increases insulin resistance. Metformin is still undergoing tests for usefulness in the treatment of AEs, but studies have shown that it improves ovulation and possibly reduces androgen levels. However, it is not known whether metformin prevents the development of endometrial cancer, like oral contraceptives or hormone replacement therapy (receiving progesterone).

Medications to reduce hirsutism (excess body hair)

Among the several preparations for the treatment of IL physician may add some medicaments intended in particular to reduce hair growth under the influence of excessive estrogen Estrogen - the key to bone health   in the body. Spironolactone (aldactone) blocks the effects of androgens and reduces the production of new androgen. Spironolactone - a diuretic, so during his reception frequent urge to urinate. Possible side effects include heartburn, headaches and fatigue. To reduce the level of androgen also prescribed finasteride (Propecia, Proscar) and flutamide (Eulexin).

It is also possible treatment eflornithine (Vaniqa) - cream, slows the growth of facial hair in women. Apply the cream should be used twice a day. During pregnancy, it is not recommended to use eflornithine.

Medication to increase the probability of conceiving

To become pregnant, women with PCOS need medication stimulates ovulation. Clomiphene (Clomid, Serophene) - anti-estrogen drug that should be taken during the first five days of the menstrual cycle The days of the menstrual cycle: Four phases . If clomiphene is ineffective, metformin was added thereto to stimulate ovulation.

If desired pregnancy does not occur even after clomiphene and metformin, administered gonadotropin therapy, in particular, follicle stimulating and luteinizing hormones which are administered by injection. Because many women with PCOS have an increased level of luteinizing hormone, commonly prescribed therapy only FSH.

Stimulation of ovulation

If PCOS is one of the symptoms of anovulatory primary infertility .  In order to stimulate ovulation uses several methods of therapeutic effect .  First-line therapy can be called clomiphene .  It is prescribed strictly ascending pattern, beginning with a dose of 50 mg .  Subsequently, the dose is increased, thus evaluate treatment efficacy based on the results ultrasonograph .  In the course of the US should determine the size of the follicle, the presence of the dominant follicle and the endometrium .  Clomiphene may be administered in the first phase of the cycle of the fifth to the ninth day, or the third to seventh day .  Most effective therapy is observed in the availability of stored body's estrogen saturation, when the level of estrogen is not changed (for the study of estradiol) .  In the case where the level of estrogens in women is inadequate when conducted ovulation stimulation with clomiphene does not give adequate folliculogenesis process, it is necessary to select a method using gonadotropin stimulation .

The drugs of choice are menotropiny or urofollitropin at a dose of 150 to 225 IU per day .  Stimulation of ovulation is carried out in a first phase with the third or fifth day for seven days .  You can continue treatment up to fifteen days .  The duration of treatment, its effectiveness, adequate dose can be based on an assessment of the dynamics of growth of the follicle .  Therapy is considered effective if the follicle growth per day is at least 2 mm by ultrasound .  If the follicle growth is slow, it is necessary to increase the dose of 75 IU .  In the case of the opposite situation, when there is an excessive rate of growth of the follicle, it is necessary to reduce the dose of 75 IU .  The appointment of the drug can be stopped when the follicle reaches a size of 18-20 mm, and the thickness of the endometrium will not be less than 8 mm .  This situation is a confirmation of ovulation, so welcome menotropinov stop, once added to the therapy of HCG (human chorionic gonadotropin) at a dose of 10,000 U .  It is sure to be carried out support the second phase of the cycle, after ovulation fact confirmed .  Hormonal support held the appointment of progestogens such as dydrogesterone at a daily dose to 30 mg .  Selection of an individual dose, so in some cases the dose may exceed the average therapeutic or be lower .

Lack of effect of ongoing methods of ovarian stimulation is an indication for surgery (resection of the ovaries and other interventions), which is considered an important adjunct to conservative therapy.